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r r r r r r r r r r r r r r r r r r <br /> Advanced CHAINS� ��� <br /> OF CUSTODY RECORD <br /> ' GeciEnvironmental, Inc. Date C z A Page a- of a <br /> 837 Shaw Road- Stockton, California- 85215 • (209) 467-1006- Fax (209)467-1118 <br /> Client Project Manager <br /> 1 �U f' Tests Required <br /> Phone Number <br /> Samplers: (Signature) x�t Invoice: <br /> Project Name Q ° AGEe <br /> IyU Client <br /> Sample Location Sample Type No. of L <br /> Number Description Date Time Water Air Solid Conts. �� ` Notes <br /> Comp. Grab. 1 t' �.� <br /> P L- Y io v q/0x x x #3' s` <br /> t <br /> e in is a y: rg ece ve y: (Signature) 15 j p TAT Date/Tlme <br /> • <br /> Reli uished b (Signature) Received by: (Signature) Dale/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Dale/Tlme <br /> Dispatched by: (Signature) Date/Time Roo My Laboratory by: Dale rime <br /> Method of Shipment: _ ` Laboratory me <br /> vC 4 ) �e <br /> Special Instructions: IF I hereby <br /> r^a—uthoriz the performance of the above Indicated work. <br /> 1 <br />